IN INDONESIA Introduction Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course? References Pedoman Kerja Puskesmas, Depkes RI Sistim Kesehatan Nasional Renstra Depkes 2005-2009 Standar Pelayanan Minimal Bidang Kesehatan What is PUSKESMAS? Functional health organization unit Public health development center Building community participation Provide comprehensive and integrated services to the community under its coverage in the forms of principal activities PUSKESMAS coverage Part of or the whole sub-district (kecamatan), depending on: Population density (~30,000) Areas (~district head office) Geographic (extended to have supporting-Puskesmas/Puskesmas Pembantu or Puskesmas Keliling) Infrastructure (personnel and facilities) PUSKESMAS coverage Especially for big cities (population 1 million) = Puskesmas Pembina: Coverage: sub-district Population: 150,000 Referral and Coordinating several Puskesmas Kelurahan (village-level) Comprehensive health service
Promotion Prevention
Cure/treatment
Rehabilitation
for all gender and age from conception
to those dying Integrated health services All principal health service activities: Policlinic Maternal and child clinic Hygiene and sanitation program Communicable diseases program And others implemented together under one coordination and leader Functions and roles of PUSKESMAS in the public health system Functions: Public health development center Building community participation to promote healthy life behaviors Provide comprehensive and integrated health care services Functions and roles of PUSKESMAS in the public health system Activities: Stimulating the community to do self-help activities Informing the community to search and use the locally available resources effectively and efficiently Technically assisting the community for medical content, medical and health referral without rising any dependency Providing direct health services to the community Collaborating with other related sectors in implementing the health programs Functions and roles of PUSKESMAS in the public health system Roles: As a technical implemental institution, it shall have a managerial capabilities and long-term vision to improve the quality of health services In planning, managing and evaluating Using and updating related information techniques to improve the comprehensive and integrated health services Functions and roles of PUSKESMAS in the public health system Status: Administration, as a technical unit of district government office via the district health office Hierarchical health service, as a primary health service facility (*) Organization of PUSKESMAS HEAD OF PUSKESMAS
HEAD OF ADMINISTRATION UNIT
TECHNICAL UNIT SUPPORTING TECHNICAL UNIT
I-III UNIT IV-VII Organization of PUSKESMAS
PERSONNEL JOB DESCRIPTION
Head of Leading, supervising and Puskesmas coordinating Puskesmas activities (structural and functionally) Head of Staffing, finance, facility, Administration recording and reporting unit Organization of PUSKESMAS
PERSONNEL JOB DESCRIPTION
Unit I Maternal and child health, family planning and nutrition program activities
Unit II Prevention and treatment of
communicable diseases (immunization, environmental health and laboratory) Organization of PUSKESMAS
PERSONNEL JOB DESCRIPTION
Unit III Dental and oral health, occupational health and elderly
Unit IV Public health nursing, school
and sport health, mental health, eyes health and other specific healths Organization of PUSKESMAS
PERSONNEL JOB DESCRIPTION
Unit V Building and developing community health activities and public health promotion
Unit VI Out-patient and in-patient
treatment services Unit VII Pharmacy Organization of PUSKESMAS SUPPORTING JOB DESCRIPTION UNIT Supporting Implementing Puskesmas Puskesmas programs to 2,500 10,000 population
Mobile Implementing Puskesmas
Puskesmas programs to remote areas Village midwife Provide maternal and child health service to 3,000 population Primary Programs of PUSKESMAS 1. Maternal and child health 2. Family Planning 3. Nutrition Improvement 4. Environmental health 5. Communicable diseases eradication 6. Treatment, including emergency condition 7. Public health education/promotion 8. School health program 9. Sport health 10.Public health nursing Primary Programs of PUSKESMAS 11. Occupational health 12. Dental and oral health 13. Mental health 14. Eyes health 15. Laboratory 16. Reporting and recording of health information system 17. Elderly 18. Controlling traditional healer 19. And others Referral system Hierarchy Health service component Households Individual or family members Community Households of ten, Posyandu Primary Puskesmas and its supporting health service units, private practices, etc facility Primary District hospital, laboratory, referral unit private practices, etc Advanced Provincial hospitals, special referral unit health facilities, etc Referral system Type of referral system: Medical referral (diagnostic and treatment): patient consultation, sending specimens and inviting special health personnel Health referral (promotion and prevention): epidemiological survey and eradication of outbreaks, food aids, investigation of food poisoning, special aids during disaster and displaced population/refugee, clean water technology and laboratory Conclusion Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course?